{"id":127273,"date":"2024-08-30T20:42:50","date_gmt":"2024-08-30T20:42:50","guid":{"rendered":"https:\/\/todaysveterinarynurse.com\/?p=127273"},"modified":"2024-08-30T20:42:50","modified_gmt":"2024-08-30T20:42:50","slug":"limiting-the-zoonotic-risks-of-bacterial-infections","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/infectious-disease\/limiting-the-zoonotic-risks-of-bacterial-infections\/","title":{"rendered":"Limiting the Zoonotic Risks of Bacterial Infections"},"content":{"rendered":"<div class=\"su-spacer\" style=\"height:20px\"><\/div><div class=\"su-note\"  style=\"border-color:#d8d8d8;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><div class=\"su-note-inner su-u-clearfix su-u-trim\" style=\"background-color:#f2f2f2;border-color:#ffffff;color:#333333;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><b>Abstract<\/b><\/p>\n<p class=\"p1\">Animals benefit people in many ways. They are service dogs, emotional support animals, companions, and travel partners. However, they can also carry diseases that may be transmissible to humans. Several of these zoonotic diseases are caused by bacteria. It is important for veterinary nurses to be able to handle these patients safely and to discuss zoonotic bacterial infections with clients, including how to prevent exposure of their pet and how to protect themselves if their pet is infected.<\/p>\n<p><b>Take-Home Points <\/b><\/p>\n<ul>\n<li class=\"p1\">Antimicrobial stewardship is an important part of preventing antibiotic resistance.<\/li>\n<li class=\"p1\">Keeping the environment clean is important in preventing the spread of infections.<\/li>\n<li class=\"p1\">Hand hygiene is the No. 1 way to prevent infections.<\/li>\n<li class=\"p1\">Most of the bacterial zoonotic diseases seen in the United States are found in both urban and rural settings.<\/li>\n<li class=\"p1\">Client communication is paramount to reducing the zoonotic potential of bacterial infections.<\/li>\n<\/ul>\n<\/div><\/div>\n<p class=\"p1\"><span class=\"s1\">T<\/span><span class=\"s1\">he <a href=\"https:\/\/todaysveterinarynurse.com\/personal-professional-development\/history-and-science-of-the-human-animal-bond\/\" target=\"_blank\" rel=\"noopener\">human\u2013animal bond<\/a> takes many forms: service dog, emotional support animal, companion animal, travel partner, family member. This close relationship puts people at risk of being exposed to zoonotic diseases\u2014that is, diseases that can be transmitted from animals to humans.<sup>1<\/sup> Many of these diseases are caused by bacteria, some of which are resistant to antibiotics.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Although some zoonotic bacterial infections may have grave consequences for humans and animals, many are preventable. It is therefore important for veterinary nurses to be able to discuss potential bacterial zoonotic diseases with clients, including how to protect their pet from exposure as well as how to protect themselves, other family members, and possibly other pets if exposure has already occurred. It is essential that veterinary nurses know how to protect themselves and <a href=\"https:\/\/todaysveterinarynurse.com\/infectious-disease\/preventing-hospital-infections\/\" target=\"_blank\" rel=\"noopener\">prevent transmission within the clinical setting<\/a>, as well as how to educate owners about the risks of zoonotic bacterial infections and how to prevent them.<\/span><\/p>\n<h2 class=\"p3\">Overview of Zoonotic Disease<\/h2>\n<p class=\"p2\"><span class=\"s1\">Zoonotic diseases are found worldwide and account for many newly recognized infectious diseases, as well as existing ones.<sup>2<\/sup> They can be caused by bacteria, viruses, fungi, or parasites and are transmitted by direct or indirect exposure, depending on the pathogen. Certain zoonotic diseases can be transmitted back to animals from humans (known as reverse zoonosis or zooanthroponosis), and others may eventually transform to become human-only diseases. Globally, zoonotic diseases are commonplace, with scientists estimating that more than half of infectious diseases in humans can be spread from animals.<sup>1 <\/sup>Most of the bacterial zoonotic diseases seen in the United States are found in both urban and rural settings. Pets can be exposed while indoors or outdoors. Infected pets may not show clinical signs of disease, making it difficult for the veterinary team to identify disease and for the owner to take precautions. While it is important not to create fear around potential zoonotic disease, educating clients about risk factors and proper prevention can help protect both pets and families (<\/span><span class=\"s2\"><b>BOX 1<\/b><\/span><span class=\"s1\">).<\/span><\/p>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">BOX 1 Talking to Clients About Bacterial Zoonoses<sup>3<\/sup><\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\">Veterinary nurses have an indispensable role in educating clients about how to prevent transmission of bacterial zoonotic diseases at home. Advice on measures such as good hand hygiene and pet hygiene practices is paramount. For example, immunocompromised clients should be advised to avoid activities that put them at increased risk of transmission, such as changing cat litter, cleaning up pet waste, or bathing their pet. If these tasks are unavoidable, they should wear a disposable gown and gloves and then clean their hands with either soap and water or hand sanitizer. They should also avoid receiving pet licks on their face or on broken skin. These precautions also apply to young and elderly family members. By ensuring client comprehension and the safety of all members of the household, the veterinary team helps strengthen the bond between a pet and its owner.<\/div><\/div>\n<h2 class=\"p3\">Common Bacterial Zoonotic Diseases<\/h2>\n<h3 class=\"p4\">Leptospirosis<\/h3>\n<p class=\"p2\"><span class=\"s1\"><a href=\"https:\/\/todaysveterinarynurse.com\/infectious-disease\/leptospirosis-in-dogs\/\" target=\"_blank\" rel=\"noopener\">Leptospirosis<\/a> is a zoonotic disease caused by <i>Leptospira<\/i> spirochetes. These spiral-shaped bacterial pathogens infect a wide variety of mammals worldwide.<sup>4,5<\/sup> Globally, the most important reservoir hosts are rodents, which account for a worldwide infection incidence of 30%; in some regions, the rate exceeds 80%.<sup>6<\/sup> Leptospirosis can affect several organ systems.<sup>7<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\"><i>Leptospira<\/i> bacteria colonize the renal tubules of infected animals and are shed in the urine to contaminate soil and water (e.g., lakes, streams, rivers, puddles). In mild, damp environments, they can survive and replicate for up to several months without a host. Places that have increased risk of contamination include homes with backyard poultry, composting areas, ponds\/lakes, and areas with poor sanitation and a higher rodent or wildlife population.<sup>4<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Animals can become infected via mucous membranes (including venereal or placental transfer) or abraded or broken skin (e.g., chafing, bite wounds). The most common form of transmission is contact with contaminated water.<sup>7<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">All dogs are at risk of leptospirosis, regardless of signalment, geographic location, lifestyle, and time of year.<sup>4<\/sup> Dogs with leptospirosis may present with the clinical signs listed in <\/span><span class=\"s2\"><b>BOX 2<\/b><\/span><span class=\"s1\">. Infection in dogs can cause severe damage to the kidneys and liver and can be fatal. Reports of leptospirosis in cats are rare; however, cats may be disease-resistant reservoir hosts.<sup>4<\/sup> In humans, aseptic meningitis occurs in up to 25% of <i>Leptospira<\/i> infections.<sup>4<\/sup><\/span><\/p>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">BOX 2 Clinical Signs of Leptospirosis in Dogs<sup>4,8<\/sup><\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\"><div class=\"su-row\"><div class=\"su-column su-column-size-1-2\"><div class=\"su-column-inner su-u-clearfix su-u-trim\">\n<ul>\n<li>Fever<\/li>\n<li>Lethargy<\/li>\n<li>Loss of appetite<\/li>\n<li>Vomiting<\/div><\/div> <div class=\"su-column su-column-size-1-2\"><div class=\"su-column-inner su-u-clearfix su-u-trim\"><\/li>\n<li>Joint or muscle pain<\/li>\n<li>Abdominal pain<\/li>\n<li>Ocular and nasal discharge<\/li>\n<li>Changes in urination<\/li>\n<li>Jaundice<\/div><\/div><\/div><\/div><\/div><\/li>\n<\/ul>\n<p class=\"p2\"><span class=\"s1\">Treatment in dogs can include starting with penicillin followed by doxycycline at 5 mg\/kg IV q12h for 2\u00a0weeks. Treatment should not be delayed while test results are awaited. Supportive care for blood pressure management and gastrointestinal disturbances should be considered.<sup>4<\/sup><\/span><\/p>\n<p class=\"p5\"><b>Precautions<\/b><\/p>\n<p class=\"p2\"><span class=\"s1\">While caring for dogs with leptospirosis in the hospital, veterinary nurses should use barrier precautions to protect skin and mucous membranes from contact with urine or blood, as these are the main routes of transmission.<sup>8<\/sup> Protective personal equipment (PPE) such as gloves, gowns or bunny suits, masks that include eye protection or face shields to protect against aerosolized urine, and shoe covers should be worn.<sup>8<\/sup> Dogs should be walked in a designated area often enough that urination does not occur accidentally in the hospital.<sup>4<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">For patients that are sent home, the client should be educated to avoid contact with urine and to wear eye protection and gloves when cleaning up urine until after the first 48 hours of antibiotics.<sup>4<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Protection against leptospirosis is provided by offering vaccination for dogs. The initial vaccines are started at 12 weeks of age and consist of 2 vaccines given 4 weeks apart. After this initial series, booster vaccination should be provided yearly.<\/span><\/p>\n<p class=\"p5\"><b>Client Education<\/b><\/p>\n<p class=\"p2\"><span class=\"s1\">It is important for the veterinary team to remember and to educate owners that all dogs are at risk of leptospirosis.<sup>4 <\/sup>Changing land use has increased the risk of contact between wildlife reservoir hosts and pets (and subsequently humans) in both city and more rural environments. Owners may not realize how at risk their pets, especially dogs, are for contracting leptospirosis.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">In addition, as different organ systems can be affected, the clinical signs of leptospirosis can vary widely. The lack of distinctive clinical features, especially in early stages, makes leptospirosis hard to diagnose. Therefore, it is imperative for veterinary teams to educate clients early and often regarding the dangers of leptospirosis and how to mitigate the risk to their pet and thereby the entire family (<\/span><span class=\"s2\"><b>BOX 3<\/b><\/span><span class=\"s1\">).<\/span><\/p>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">BOX 3 Assessing Leptospirosis Risk With Clients<\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\">Part of educating clients about bacterial zoonotic disease involves assessing risk factors. The following lifestyle questions can help dog owners identify whether their activities may place them in contact with infected wildlife or contaminated soil, water, or urine, which increases the risk of leptospirosis.<\/p>\n<ul>\n<li>Do you enjoy outdoor activities, such as hiking and camping?<\/li>\n<li>Do you take your dog with you during outdoor activities?<\/li>\n<li>Does your dog live indoors or outdoors? Is it allowed to roam?<\/li>\n<li>Do you keep food and water outside for your dog? (This may attract reservoir hosts.)<\/li>\n<li>Do you live near soil\/property used by livestock and\/or wildlife (e.g., pastures, woods, parks)?<\/div><\/div><\/li>\n<\/ul>\n<h3 class=\"p4\">Staphylococcal Infections<\/h3>\n<p class=\"p2\"><span class=\"s1\"><i>Staphylococcus<\/i> species are gram-positive bacteria in the Staphylococcaceae family.<sup>9<\/sup> Although most animals carry at least 1 <i>Staphylococcus<\/i> species, <i>Staphylococcus aureus <\/i>and <i>Staphylococcus pseudintermedius<\/i> are 2 of the species most commonly associated with infection<i>.<\/i><sup>10<\/sup> Antibiotic-resistant strains of both species exist. <i>S\u00a0pseudintermedius<\/i> is part of the normal skin flora of dogs.<sup>11<\/sup> <i>S\u00a0aureus<\/i>, which is estimated to colonize about 30% of healthy humans (primarily in the nasal cavity), is a major cause of disease in many animal species and can have significant effects on public health and agriculture.<sup>11,12<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\"><i>S\u00a0pseudintermedius<\/i> accounts for ~90% of pyoderma cases in dogs.<sup>13<\/sup> Additionally, it is associated with antimicrobial resistance in other <i>Staphylococcus<\/i> species.<sup>12<\/sup> In dogs, infections with <i>S\u00a0aureus<\/i> or <i>S\u00a0pseudintermedius<\/i> usually involve the skin. Dermal <i>S\u00a0pseudintermedius<\/i> infections tend to occur in dogs with underlying skin disorders or other health conditions.<sup>14<\/sup> <i>S\u00a0pseudintermedius<\/i> infections of the ear or urinary tract, conjunctivitis, prostatitis, and surgical site infections have also been reported.<sup>14<\/sup> Dermal <i>S\u00a0aureus<\/i> infections can look like various skin conditions, including boils or pimples, in both humans and animals; however, the infection can spread to the blood, bones, heart, or lungs and sometimes becomes fatal.<sup>15,16<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">In cats, <i>S\u00a0aureus<\/i> and <i>Staphylococcus coagulans<\/i> account for 10% of pyoderma cases.<sup>13<\/sup> <i>S\u00a0aureus<\/i> is more often associated with pyoderma in cats than is <i>S\u00a0pseudintermedius<\/i>.<sup>13<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Humans can become briefly colonized with <i>S\u00a0pseudintermedius<\/i>, but how frequently this happens is unknown. Human <i>S\u00a0pseudintermedius<\/i> infection most often occurs from dog bites. <i>S\u00a0pseudintermedius <\/i>can become invasive in humans and cause illnesses such as bacteremia, endocarditis, and device-associated infections.<sup>14<\/sup> Transmission of <i>S\u00a0aureus <\/i>from dogs to humans seems to be uncommon.<sup>11<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Methicillin-resistant <i>S\u00a0pseudintermedius<\/i> infections have become common in dogs, with some estimates of incidence as high as 40%.<sup>14<\/sup> Some strains are multidrug resistant.<sup>14<\/sup> Current guidelines for treatment of pyoderma caused by <i>S\u00a0pseudintermedius<\/i> infections recommend use of antibiotics and shampoos; however, research into alternative, nonantibiotic therapies is ongoing.<sup>17<\/sup> Methicillin-resistant <i>S aureus <\/i>(MRSA) infections have been reported in a variety of companion and exotic animal species. Healthy dogs and cats can be colonized by MRSA, but this colonization is likely transient. Dogs are much less likely to be infected or colonized with <i>S\u00a0aureus<\/i> than with <i>S pseudintermedius<\/i>.<sup>18<\/sup><\/span><\/p>\n<p class=\"p5\"><b>Risk Factors<\/b><\/p>\n<p class=\"p2\"><span class=\"s1\">Recent antimicrobial exposure, including therapy with <\/span><span class=\"s3\">\u03b2<\/span><span class=\"s1\">-lactams or fluoroquinolones, is the primary risk factor for acquiring methicillin-resistant staphylococci.<sup>18<\/sup> Additional risk factors for MRSA infection in pets include contact with an ill or hospitalized person, intravenous catheterization, and extended hospital stays.<sup>18<\/sup><\/span><\/p>\n<p class=\"p5\"><b>Precautions<\/b><\/p>\n<p class=\"p6\"><span class=\"s1\"><i>S\u00a0aureus<\/i> can survive in temperatures ranging from 7 \u00b0C to 48 \u00b0C (44.6 \u00b0F to 118.4 \u00b0F),<sup>19<\/sup> and for up to 72 hours on stainless steel surfaces and up to 28 days on dry mops.<sup>20 <\/sup><i>S\u00a0pseudintermedius<\/i> can survive on environmental surfaces for several months. Veterinary teams should follow strict hygiene practices to control transmission of methicillin-resistant staphylococci. Practical hygiene practices include:<\/span><\/p>\n<ul>\n<li class=\"p7\"><span class=\"s1\">Use of PPE, such as disposable gloves, when working with infected patients<\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Covering open or draining wounds<\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Frequent cleaning of infected patients\u2019 dishes, bedding, cages, and leashes<\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Environmental disinfection<\/span><\/li>\n<li class=\"p8\"><span class=\"s1\">Regular handwashing, especially after handling infected patients and between patients<\/span><\/li>\n<\/ul>\n<p class=\"p5\"><b>Client Education<\/b><\/p>\n<p class=\"p2\"><span class=\"s1\">In the home environment, many <i>Staphylococcus<\/i> infections can be prevented by washing hands thoroughly with soap and water or using an alcohol-based hand sanitizer.<sup>15<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Strict hygiene practices are critical to limit transmission of methicillin-resistant staphylococci. Owners should be advised to wear gloves when interacting with an infected pet. In addition, the veterinary team must educate the pet owner to clean the pet\u2019s environment, including bedding, dishes, and collars\/harnesses, and remind them to wash their hands before and after every interaction. Owners must understand that their pet cannot be allowed to sleep in bed with them and should be prevented from licking them or items in the environment.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">It is imperative for the veterinary team to record client education recommendations in the patient\u2019s medical record. Giving the client recommendations in writing along with a veterinary team member\u2019s contact information can be helpful.<\/span><\/p>\n<h3 class=\"p4\">Salmonellosis<\/h3>\n<p class=\"p2\"><span class=\"s1\"><i>Salmonella<\/i> bacteria are gram-negative, rod-shaped bacteria that belong to the Enterobacteriaceae family. There are 2 main species that have several subspecies and serotypes.<sup>21<\/sup> Humans and animals usually become infected by consuming contaminated food or water.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Most animals infected with <i>Salmonella<\/i> have no clinical signs of illness; however, the most common syndromes associated with <i>Salmonella<\/i> are systemic septicemia and enteritis. Dogs and cats with <i>Salmonella<\/i> usually have acute diarrhea with or without septicemia. Sheep, adult cattle, and horses can also develop enteritis. Less common clinical presentations include abortion, arthritis, respiratory disease, necrosis of the extremities, and meningitis.<sup>22<\/sup> In humans, salmonellosis usually results in acute gastroenteritis, which can be severe.<sup>21<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Pet reptiles often have <i>Salmonella<\/i> in their gastrointestinal tract and can periodically shed the bacteria in feces. <i>Salmonella <\/i>does not cause illness in reptiles, but bacteria shed by reptiles can cause illness in humans and other animals, either through direct contact with the reptile or from handling or ingesting material contaminated with reptile waste.<sup>23<\/sup><\/span><\/p>\n<p class=\"p5\"><b>Precautions<\/b><\/p>\n<p class=\"p2\"><span class=\"s1\"><a href=\"https:\/\/todaysveterinarynurse.com\/nutrition\/alternative-pet-diets-grain-free-raw-and-other-trends\/\" target=\"_blank\" rel=\"noopener\">Raw diets<\/a> have been associated with salmonellosis in dogs and cats because these diets do not undergo a processing step to kill bacteria, including <i>Salmonella<\/i>.<sup>24<\/sup> Therefore, feeding a raw diet to a cat or dog is not recommended by the U.S. Centers for Disease Control and Prevention (CDC).<sup>25<\/sup> Owners may need to be educated on the risks of raw diets.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Anyone handling a pet with a <i>Salmonella<\/i> infection should use strict hand hygiene and keep the environment as clean as possible. In the veterinary hospital, it is important not to eat or drink in animal areas and not to kiss high-risk animals such as reptiles. Surfaces should be sanitized.<\/span><\/p>\n<p class=\"p5\"><b>Client Education<\/b><\/p>\n<p class=\"p2\"><span class=\"s1\">Proper hygiene, including hand washing after interacting with animals, must be reinforced to pet owners, especially if the pet is exhibiting signs of illness (e.g., diarrhea, vomiting) or if the pet is a reptile, amphibian, or a flock of backyard chickens. Children younger than 5 years and people with weakened immune systems should not touch or play with pets or animals likely to carry <i>Salmonella<\/i>. No one in the household should eat or drink around these animals or their living areas. If possible, the pet\u2019s food bowls, toys, and bedding should be disinfected outside, but cleaning in a dishwasher or with bleach is an acceptable alternative.<\/span><\/p>\n<h3 class=\"p4\">Bartonellosis<\/h3>\n<p class=\"p2\"><span class=\"s1\">While several <i>Bartonella<\/i> species are suspected of causing disease in humans, the primary species of zoonotic concern are <i>Bartonella henselae<\/i> and <i>Bartonella clarridgeiae.<\/i> These gram-negative intracellular bacilli are carried by arthropods (commonly fleas), which infect animals through their bite. Cats are the primary reservoir for infection in humans. Humans can also be infected through flea bites, but transmission via a cat scratch or bite contaminated with feces from infected fleas is more common. In humans, the resulting disease (cat scratch disease) can be life-threatening.<sup>26<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">The most common clinical signs of bartonellosis in dogs are indicative of infective endocarditis (e.g., lethargy, fever, heart murmur, cough, tachypnea, lameness). Cats are commonly healthy carriers; however, fever, endocarditis, myocarditis, and transient lymphadenopathy have been seen in cats. <i>Bartonella<\/i> infection may also lead to other systemic inflammatory disorders.<sup>27,28<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">In immunocompetent humans, common symptoms of bartonellosis include swollen lymph nodes, fever, and bumps or a rash on the skin. More severe disease, such as bacteremia, endocarditis, and proliferative lesions, can occur in high-risk patients. Children (especially those aged 5 to 9 years) appear to be at greatest risk of cat scratch disease.<sup>26<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">According to the CDC, most cat scratches do not result in disease; however, if symptoms develop within 1 to 3\u00a0weeks a physician should be seen for treatment recommendations.<sup>29<\/sup> Treatment of infected cats is only recommended for those with clinical signs of disease, and diagnosis of infection requires culture or<span class=\"Apple-converted-space\">\u00a0 <\/span>polymerase chain reaction testing.<sup>28<\/sup><\/span><\/p>\n<p class=\"p5\"><b>Client Education<\/b><\/p>\n<p class=\"p2\"><span class=\"s1\"><a href=\"https:\/\/todaysveterinarynurse.com\/parasitology\/educating-clients-about-flea-prevention\/\" target=\"_blank\" rel=\"noopener\">Flea control<\/a> is essential to reduce the spread of <i>Bartonella<\/i> infection among cats, dogs, and humans. Veterinary teams should educate owners regarding proper training and handling of cats and dogs to reduce bites and scratches, especially in households with high-risk people. Avoiding bites and scratches is even more important when dealing with animals likely to be infected (e.g., kittens, feral cats, outdoor cats, cats with fleas). Educating owners about the importance of trimming their cats\u2019 nails should be undertaken to reduce the chance of skin lacerations. It is also important to educate owners to keep cats indoors, as this can reduce the risk of infection.<\/span><\/p>\n<p class=\"p6\"><span class=\"s1\">High-risk households should consider the following recommendations<sup>27,29<\/sup>:<\/span><\/p>\n<ul>\n<li class=\"p7\"><span class=\"s1\">Adopt healthy cats older than 1 year to reduce the risk of bites and scratches from rough play<\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Maintain flea control<\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Promptly wash cat bites and scratches<\/span><\/li>\n<li class=\"p8\"><span class=\"s1\">Prevent cats from licking wounds on people<\/span><\/li>\n<\/ul>\n<h2 class=\"p3\">Antibiotic-Resistant Infections<\/h2>\n<p class=\"p2\"><span class=\"s1\">The continuing emergence of antibiotic-resistant infections is a global public health concern and a focus of One Health efforts.<sup>30<\/sup> One emerging concern is the development of carbapenem-resistant Enterobacterales (CRE),<i> <\/i>including carbapenem-resistant <i>Escherichia coli<\/i> and <i>Klebsiella pneumoniae<\/i>. CRE can infect humans and animals. Although the zoonotic risk to healthy people appears to be low and information about modes of CRE transmission in veterinary settings is currently limited, CRE are difficult to treat; therefore, reducing exposure risk is paramount.<sup>3<\/sup> In addition to the precautions listed in <\/span><span class=\"s2\"><b>BOX 4<\/b><\/span><span class=\"s1\">, CRE-infected animals in the veterinary hospital should be isolated to protect other animals and veterinary personnel.<\/span><\/p>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">BOX 4 General Clinical Practices to Prevent Bacterial Transmission<sup>3<\/sup><\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\">1. Keep hands and the environment clean.<\/p>\n<ul>\n<li>Routinely clean and disinfect all surfaces, including equipment (e.g., stethoscopes, scissors, clippers) between uses and whenever visibly soiled. The longer a surface remains contaminated, the greater the risk of that surface transferring pathogens to a patient or person.<\/li>\n<li>Wash hands with soap and water for 20 seconds or use hand sanitizer between patients. Even if gloves and other personal protective equipment (PPE) are worn, hand hygiene is a vital way to prevent the spread of disease.<\/li>\n<\/ul>\n<p>2. Use barrier precautions (e.g., gloves, goggles, other PPE) when performing procedures that might create exposure to potentially infectious materials.<\/p>\n<p>3. Consider having an antimicrobial stewardship program to ensure the correct drugs are used cautiously.<\/p>\n<p>4.Educate clients that antibiotics may not always be the right choice for treating their pet.<\/div><\/div>\n<p class=\"p6\"><span class=\"s1\">Having an antimicrobial stewardship program in place can help reduce the development of antimicrobial resistance.<sup>31<\/sup> The AVMA encourages veterinary professionals to implement antimicrobial stewardship to improve antimicrobial prescribing.<sup>32<\/sup> The core principles of such a program include<sup>32<\/sup>:<\/span><\/p>\n<ul>\n<li class=\"p7\"><span class=\"s1\">Engaging all team members in the stewardship effort<\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Advocating for a practice structure to stop common diseases from occurring<\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Choosing and using antimicrobial drugs cautiously<\/span><\/li>\n<li class=\"p8\"><span class=\"s1\">Educating clients about appropriate use of antibiotics<\/span><\/li>\n<\/ul>\n<h2 class=\"p3\">Summary<\/h2>\n<p class=\"p2\"><span class=\"s1\">The human\u2013animal bond between an owner and a pet is mutually beneficial and is essential to the health and wellbeing of both parties.<\/span> <span class=\"s1\">However,<\/span> <span class=\"s1\">pet ownership may also put people at risk for exposure to zoonotic diseases. It is critically important that the veterinary team be aware of potential zoonotic disease, understand how these diseases are transmitted, and educate clients about not only the disease and its potential for transmission but also how to mitigate the risk for transmission.<\/span><\/p>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">Recommended Reading<\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\"><strong>Antimicrobial stewardship<\/strong><\/p>\n<ul>\n<li>AVMA antimicrobial stewardship definition and core principles (<a href=\"http:\/\/go.navc.com\/3WNoLTH\" target=\"_blank\" rel=\"noopener\">go.navc.com\/3WNoLTH<\/a>)<\/li>\n<li>Centers for Disease Control and Prevention (CDC) core elements of antibiotic stewardship (<a href=\"http:\/\/go.navc.com\/4d8s4ul\" target=\"_blank\" rel=\"noopener\">go.navc.com\/4d8s4ul<\/a>)<\/li>\n<\/ul>\n<p><strong>Carbapenem-resistant Enterobacterales<\/strong><\/p>\n<ul>\n<li>CDC carbapenem-resistant Enterobacterales and veterinarian basics (<a href=\"http:\/\/go.navc.com\/3SD57HB\" target=\"_blank\" rel=\"noopener\">go.navc.com\/3SD57HB<\/a>)<\/li>\n<\/ul>\n<p><strong>Diagnostic testing for bacterial zoonotic disease<\/strong><\/p>\n<ul>\n<li>Bartonellosis\n<ul>\n<li>CDC veterinary guidance for Bartonella (<a href=\"http:\/\/go.navc.com\/3LUUufG\" target=\"_blank\" rel=\"noopener\">go.navc.com\/3LUUufG<\/a>)<\/li>\n<li>European Advisory Board on Cat Diseases guideline for feline bartonellosis (<a href=\"http:\/\/go.navc.com\/3YxuQVN\" target=\"_blank\" rel=\"noopener\">go.navc.com\/3YxuQVN<\/a>)<\/li>\n<\/ul>\n<\/li>\n<li>Merck Veterinary Manual leptospirosis in dogs (<a href=\"http:\/\/go.navc.com\/3SC6pCS\" target=\"_blank\" rel=\"noopener\">go.navc.com\/3SC6pCS<\/a>)<\/li>\n<li>CDC Staphylococcus aureus basics (<a href=\"http:\/\/go.navc.com\/3WRK0UA\" target=\"_blank\" rel=\"noopener\">go.navc.com\/3WRK0UA<\/a>)<\/li>\n<li>Merck Veterinary Manual salmonellosis in animals (<a href=\"http:\/\/go.navc.com\/46HbXBO\" target=\"_blank\" rel=\"noopener\">go.navc.com\/46HbXBO<\/a>)<\/li>\n<\/ul>\n<p><strong>Raw pet food (for owners)<\/strong><\/p>\n<ul>\n<li>DC raw pet food (<a href=\"http:\/\/go.navc.com\/3LSAWIB\" target=\"_blank\" rel=\"noopener\">go.navc.com\/3LSAWIB<\/a>)<\/li>\n<\/ul>\n<p><strong>Other resources<\/strong><\/p>\n<ul>\n<li>CDC veterinary resources (<a href=\"http:\/\/go.navc.com\/3SDx1Dc\" target=\"_blank\" rel=\"noopener\">go.navc.com\/3SDx1Dc<\/a>)<\/div><\/div><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Zoonotic bacterial diseases of interest include leptospirosis, staphylococcal infections, salmonellosis, bartonellosis, and carbapenem-resistant Enterobacterales.<\/p>\n","protected":false},"author":236,"featured_media":127277,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":0,"footnotes":""},"categories":[805],"tags":[145],"class_list":["post-127273","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fall-2024","tag-peer-reviewed","column-zoonotic-risks","clinical_topics-infectious-disease"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Limiting the Zoonotic Risks of Bacterial Infections | Today&#039;s Veterinary Nurse<\/title>\n<meta name=\"description\" content=\"Zoonotic bacterial diseases of interest include leptospirosis, staphylococcal infections, salmonellosis, bartonellosis, and 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